Sonrotoclax Plus Zanubrutinib in Patients With Relapsed/Refractory Mantle Cell Lymphoma Planned for Standard of Care CAR-T Cell Therapy

Exclusion Criteria

• •Participants must enter the study while on a BTKi or enroll to a substudy of the protocol to receive zanubrutinib for a minimum duration prior to enrolling to the main study.
• •Participants previously exposed to zanubrutinib are eligible irrespective of response to treatment.
• •Participants entering the study while on a BTKi must have their BTKi switched to zanubrutinib supplied through the study.
• •Participants must have recovered to ≤ grade 1 from all reversible toxicity related to prior therapies.
• •Adequate washout must be followed per protocol.
• •Prior high-dose myelosuppresive radiation is permitted ≥28 prior to enrollment.
• •Previous major surgery is permitted ≥28 days prior to enrollment. Participants of childbearing potential must have agreed to use a highly effective contraceptive method.
• •• Participants on active anticancer therapy for other advanced or metastatic malignancies.
• •Concurrent treatment with other anti-cancer therapy
• •Serious illnesses or medical conditions which would not permit the participant to be managed according to the protocol.
• •Known hypersensitivity to the study drug(s) or their components.
• •Prior CD19-directed CAR-T at any time, autologous hematopoietic cell transplantation within 6 weeks, or allogeneic hematopoietic cell transplantation within 3 months. Allogeneic hematopoietic cell transplantation recipients must be free of clinically-significant graft-versus-host disease (GvHD) and must be off immunosuppression for GvHD for at least 4 weeks before enrollment.
• •Untreated and/or uncontrolled cardiovascular conditions and/or symptomatic cardiac dysfunction (including cardiac ventricular arrhythmias requiring medication, history of 2nd or 3rd degree atrioventricular conduction defects) or unstable angina congestive heart failure or myocardial infarction within the previous year.
• •Active, uncontrolled bacterial, fungal, or viral infection within 14 days prior to enrollment
• •Pregnant or breastfeeding women.
• •Inability to discontinue use of moderate or strong CYP3A inducers or inhibitors during the ramp-up treatment period with sonrotoclax.
• •Live vaccination within 4 weeks prior to enrollment or who plan to receive a live vaccine during treatment or within 90 days post last dose.
• •Inability to swallow capsules or tablets or have any diseases significantly affecting GI function
• •Active central nervous system (CNS) disease; Participants with stable CNS disease are eligible.
• •Growth factors within 28 days prior to enrollment.